Comparison of radiographic scoring systems for assessment of bone healing after tibial plateau leveling osteotomy in dogs.

Autor:	Leal RA; College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States., Lambrechts NE; College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States., Crowley JD; Small Animal Specialist Hospital, North Ryde, NSW, Australia., Griffin JF 4th; Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX, United States., Karnia JJ; College of Veterinary Medicine, University of Missouri, Columbia, MO, United States., Torres BT; College of Veterinary Medicine, University of Missouri, Columbia, MO, United States., Maritato KC; MedVet Medical and Cancer Center for Pets, Cincinnati, OH, United States., Kieves NR; College of Veterinary Medicine, Ohio State University, Columbus, OH, United States., Duerr FM; College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in veterinary science [Front Vet Sci] 2023 Apr 06; Vol. 10, pp. 1147386. Date of Electronic Publication: 2023 Apr 06 (Print Publication: 2023).
DOI:	10.3389/fvets.2023.1147386
Abstrakt:	Introduction: Accurate radiographic assessment of bone healing is vital in determining both clinical treatment and for assessing interventions aimed at the promotion of bone healing. Several scoring systems have been used to evaluate osteotomy changes following tibial plateau leveling osteotomy (TPLO). The goal of this study was to compare the ability of five radiographic scoring systems to identify changes in bone healing following TPLO over time (Aim I), and to evaluate the influence of limb positioning on TPLO osteotomy scoring (Aim II). Materials and Methods: Phase I-A randomized, blinded, prospective study was conducted using similarly positioned postoperative TPLO radiographs from seven dogs taken immediately postoperatively, 6-weeks, and 8-weeks postoperatively. Ten reviewers assessed the radiographs, and five different scoring systems were tested for each set including three previously published ones, a Visual Analog Score (VAS), and a subjective 11-point scale. For each system, responses for 6-week postoperative were compared to 8-week postoperative. Scores were judged as correct (=showing an increase in score), incorrect (=decrease in score), or unchanged (=same score). Phase II-An international group of 39 reviewers was asked to score radiographs from three dogs, taken in different positions, using the VAS grading system. Scores were averaged and comparisons were made for each set. Results: Phase I-The VAS system identified the greatest number of sets correctly (76%), with the least unchanged scores (15%), and 9% incorrect scores. Phase II-All three patients had an increase in the average difference between VAS-scores for differently positioned radiographs compared to similarly positioned radiographs. The magnitude of change between different positions far exceeded the magnitude of comparison of the similarly positioned radiographs from the 6- and 8-week time point. Discussion/conclusion: The VAS system appears to be the most appropriate of the tested systems to identify small changes in bone healing. In addition, the positioning of postoperative TPLO radiographs makes a substantial difference in the healing score that is assigned. Care must be undertaken when performing postoperative radiographs in both the clinical and research setting to ensure accurate assessment of bone healing. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Leal, Lambrechts, Crowley, Griffin, Karnia, Torres, Maritato, Kieves and Duerr.)
Databáze:	MEDLINE
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